Anejaculation: Causes and Treatments

Anejaculation is a condition in which a man is unable to ejaculate semen, either during sexual intercourse or through masturbation. Find out the treatment options for this condition.

Dr. Shara Cohen
By The Promescent Team Medically reviewed by Dr. Shara Cohen Last updated 12/11/2023
ڤَيتا فلَكس®

ڤَيتا فلَكس®



Just arrived in store
staff pick
Arrow pointing right

what is ejaculation

Anejaculation is a condition in which a man is unable to ejaculate semen, either during sexual intercourse or through masturbation.

It can cause them to feel less sexual enjoyment and affect their ability to conceive. Some of the main causes of anejaculation include nerve damage and cancer treatments.

Quick FAQs

Anejaculation can be caused by physical issues such as nerve damage, psychological issues such as performance anxiety, and medical issues such as taking antidepressants.

Healthcare professionals diagnose anejaculation through reviewing medical history, doing a physical examination, and taking additional tests as needed.

Some treatments for anejaculation include behavioral therapy, medications, and surgical intervention.

This guide will delve into the different types of anejaculation, their causes, how they are diagnosed, and the various treatment options available.

Types of Anejaculation

According to current research, there are over 12,000 new cases of anejaculation reported yearly. 

There are two primary types of anejaculation: situational and total. It's important to distinguish between these two types in order to determine the most appropriate course of treatment.

Situational Anejaculation

Situational anejaculation occurs when a man is unable to ejaculate in specific circumstances, but can do so in others. 

For example, he may be able to ejaculate during masturbation or have nocturnal emissions, but not ejaculate during sexual intercourse.

Total Anejaculation

Total anejaculation is the complete inability to ejaculate, regardless of the situation or circumstance. This type of anejaculation can be further divided into two subtypes: primary and secondary.

  • Primary Anejaculation: Men with primary anejaculation have never been able to ejaculate.
  • Secondary Anejaculation: Men with secondary anejaculation were once able to ejaculate, but have since lost the ability.

Additionally, total anejaculation can be divided into anorgasmic and orgasmic ejaculation:

  • Anorgasmic anejaculation: Men with anorgasmic anejaculation are unable to achieve an orgasm and ejaculate.
  • Orgasmic anejaculation: Men with orgasmic anejaculation can achieve an orgasm but are unable to ejaculate

Causes of Anejaculation

According to Dr. Shara Cohen of Cancer Care Parcel, anejaculation can be brought on by a variety of issues, including medication, nerve damage, hormone imbalances, mental health issues, or physical conditions. Understanding the underlying cause is essential for determining the appropriate treatment.

Physical Causes

Some men may experience anejaculation due to physical issues, such as:

  • Nerve damage
  • Spinal cord injury
  • Pelvic surgery
  • Diabetes
  • Multiple sclerosis

Psychological Causes

When there is no organic cause present, a person may be suffering from psychogenic anejaculation. It’s rare a problem in that it only makes 0.4%-0.5% of patients with this condition. Here are some of the potential psychological causes:

  • Stress
  • Performance Anxiety
  • Relationship issues
  • Fear of pregnancy or sexually transmitted infections

Expert Insight: If you think your anejaculation is being caused by Psychological issues, then sex therapist may help.

Medical Causes

Certain medications and medical procedures can also cause anejaculation:

  • Antidepressants
  • Antipsychotics
  • High blood pressure medications
  • Prostate surgery

Diagnosing Anejaculation

To diagnose anejaculation, healthcare professionals will consider the patient's medical history, perform a physical examination, and may request additional tests.

Medical History

The patient's medical history will provide valuable information about any underlying conditions, medications, and previous surgeries that may be contributing to anejaculation.

Physical Examination

A physical examination will help the healthcare professional assess the patient's overall health and identify any abnormalities in the genital area.

Additional Tests

Depending on the findings during the medical history and physical examination, the healthcare professional may order further tests such as a post-ejaculatory urinary analysis.

Treatment Options for Anejaculation

Dr. Cohen notes that a few treatments that could be recommended include medication, counseling, electroejaculation, and sperm retrieval. Here are some options to consider.

Behavioral Therapy

For cases of anejaculation caused by psychological factors, behavioral therapy may be recommended. This can involve:

  • Addressing performance anxiety
  • Enhancing communication with the partner
  • Exploring different sexual techniques
  • Masturbation retraining exercises to improve ejaculation control


If anejaculation is caused by a medication, the healthcare professional may suggest adjusting the dosage or switching to a different medication. In some cases, medications such as pseudoephedrine, midodrine, or imipramine may be prescribed to help stimulate ejaculation.

Assisted Reproductive Techniques

For men experiencing anejaculation due to physical issues, assisted reproductive techniques (ART) can be used to help achieve pregnancy. Some common ART methods include:

  • Electroejaculation: A procedure that involves the stimulation of nerves responsible for ejaculation through a small electrical probe.
  • Vibratory stimulation: A non-invasive technique that uses a specialized medical device to stimulate the penis and induce ejaculation.
  • Testicular sperm extraction (TESE): A surgical procedure in which sperm is extracted directly from the testicles, bypassing the need for ejaculation.

Surgical Intervention

In some cases, surgical intervention may be necessary to address an underlying issue contributing to anejaculation. One example of a surgical treatment is microsurgical denervation. It’s a procedure to sever the nerves responsible for ejaculation, which can help men with primary anejaculation.

A doctor may also recommend surgery if anejaculation is caused by a blockage due to scar tissue or an infection. Dr. Cohen notes that it’s important to seek treatment for anejaculation, as it may lead to infertility, sexual dysfunction, and other health problems.Takeaways

Anejaculation is a complex condition that can have a significant impact on a man's quality of life and fertility. 

Knowing the different types, causes, and treatment options, men can seek appropriate care and work towards a resolution. Some potential treatments for anejaculation include behavioral therapy and surgical intervention.

It's crucial to consult with a healthcare professional to develop a tailored treatment plan based on the specific cause of the condition. With the right support and treatment, many men can overcome anejaculation and achieve a satisfying sexual life.

Dr. Shara Cohen

Dr. Shara Cohen

Dr Shara Cohen (PhD, CBiol, FWIF, FRCPath, FIBMS, FRSB) has been a research scientist and lecturer with over 100 peer-reviewed scientific publications. She also has business expertise and sold her first company (which dealt with science communication), in 2016. She now works with and establishes businesses and charities which benefit local, national and international communities where she continues to share her biomedical science expertise.


Absorption Pharmaceuticals LLC (Promescent) has strict informational citing guidelines and relies on peer-reviewed studies, academic or research institutions, medical associations, and medical experts. We attempt to use primary sources and refrain from using tertiary references and only citing trustworthy sources. Each article is reviewed, written, and updated by Medical Professionals or authoritative Experts in a specific, related field of practice. You can find out more about how we ensure our content is accurate and current by reading our editorial policy.

  • Gopalakrishnan R, Thangadurai P, Kuruvilla A, Jacob KS. Situational psychogenic anejaculation: a case study. Indian J Psychol Med. 2014 Jul;36(3):329-31. doi: 10.4103/0253-7176.135393. PMID: 25035564; PMCID: PMC4100426. Accessed on May, 5, 2023.
  • Otani T. Clinical review of ejaculatory dysfunction. Reprod Med Biol. 2019 Jul 24;18(4):331-343. doi: 10.1002/rmb2.12289. PMID: 31607793; PMCID: PMC6780042. Accessed on May, 5, 2023.
  • Iudovskiĭ SO, Segal AS, Puzin MN. Anéiakuliatsiia: étiologiia i patogenez, klassifikatsiia, klinicheskie aspekty [Anejaculation: its etiology and pathogenesis, classification and clinical aspects]. Urol Nefrol (Mosk). 1995 Jul-Aug;(4):38-43. Russian. PMID: 7571201. Accessed on May, 5, 2023.
  • Gopalakrishnan R, Thangadurai P, Kuruvilla A, Jacob KS. Situational psychogenic anejaculation: a case study. Indian J Psychol Med. 2014 Jul;36(3):329-31. doi: 10.4103/0253-7176.135393. PMID: 25035564; PMCID: PMC4100426. Accessed on May, 5, 2023.
  • Cong R, Zhang Q, Wang Y, Meng X, Wang Z, Song N. Two cases of psychogenic anejaculation patients got normal ejaculation ability after penile vibratory stimulation or electroejaculation. Transl Androl Urol. 2019 Dec;8(6):758-761. doi: 10.21037/tau.2019.10.11. PMID: 32038973; PMCID: PMC6987610. Accessed on May, 5, 2023.
  • "Mums in Science - Mums in Science.", 2023, Accessed on Jul, 12, 2023.
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

مشاركة المقال: